Injections may be an option to treat or relieve orthopedic pain when you don’t need surgery in the short term or you have a condition that can get better without surgery.

Dr Spivey
Dr. Matthew Spivey

“If a patient has a condition that can be managed with non-operative treatment, their success and healing often depends on physical therapy or a home exercise program for rehabilitation. I may be able to offer injections as a way to facilitate that process and make it easier,” said Dr. Matthew Spivey at Novant Health Orthopedics & Sports Medicine - Clemmons, who specializes in orthopedic sports medicine for shoulders, knees and hips.

Simply put: Injections can offer pain relief so you can be more productive with physical therapy or rehab.

Spivey discusses three main orthopedic injections to know about.

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1. Steroid injections

How it works: Known technically as corticosteroid injections, this involves a type of steroid that acts as an anti-inflammatory agent. Anti-inflammatory medications taken by mouth like ibuprofen get absorbed and provide pain relief all through the body. With a steroid injection, we put an anti-inflammatory at the location where we think the pain is coming from. That can be more effective, more quickly – and it often is longer-lasting than a pill that you have to take multiple times a day, every day.

Of the injection options, steroid injections are probably the most commonly used due to their accessibility and effectiveness for many conditions. They can provide near-immediate relief in many patients. Your doctor may call these cortisone injections as well.

Effects: The effects of steroid injections can last several months. For folks with an injury or a problem causing them significant pain in a joint, doing injections once or twice for a short-term reason can clear the way for physical therapy.

Concerns: One common concern with steroid injections is the risk of frequent or repetitive steroid exposure. Side effects that are possible with increasing injection frequency can include cartilage damage, thinning or softening of the bone around a joint, skin color changes in a small area where injections are performed, and tendon weakening.

Accelerated onset of arthritis can be a concern for younger patients as well. If we were to do multiple steroid injections per year in one young person’s knee in their 20s over a long period of time, for example, this could lead to arthritis sooner in the joint over time.

But for older patients, steroid injections can help defer the surgical replacement of a knee, hip or shoulder. At this point in their life, the patient may be less concerned about earlier onset of arthritis. It’s already happening, and what we’ve been doing up to now isn’t working, and the alternative is a big surgery the patient is not ready for yet.

Insurance: If deemed medically necessary, corticosteroid injections are usually covered by insurance.

2. Gel hyaluronic acid injections, also called viscosupplementation